What are the symptoms of cirrhosis?

You may have no symptoms in the early stages of cirrhosis. As cirrhosis gets worse you may

feel tired or weak

lose your appetite

feel sick to your stomach

lose weight

notice red, spider-shaped blood vessels under your skin

Cirrhosis can lead to other serious problems:

You may bruise or bleed easily, or have nosebleeds.

Bloating or swelling may occur as fluid builds up in your legs or abdomen—the area between your chest and hips. Fluid buildup in your legs is called edema; buildup in your abdomen is called ascites.

Medicines, including those you can buy over the counter such as vitamins and herbal supplements, may have a stronger effect on you. Your liver does not break medicines down as quickly as a healthy liver would.

Waste materials from food may build up in your blood or brain and cause confusion or difficulty thinking.

Blood pressure may increase in the vein entering your liver, a condition called portal hypertension.

Enlarged veins, called varices, may develop in your esophagus and stomach. Varices can bleed suddenly, causing you to throw up blood or pass blood in a bowel movement.

Your kidneys may not work properly or may fail.

Your skin and the whites of your eyes may turn yellow, a condition called jaundice.

How is cirrhosis treated?

Once you have cirrhosis, nothing can make all the scar tissue go away. But treating the cause will keep cirrhosis from getting worse. For example, if cirrhosis is from heavy alcohol use, the treatment is to completely stop drinking alcohol. If cirrhosis is caused by hepatitis C, then the hepatitis C virus is treated with medicine.

Your doctor will suggest treatment based on the cause of your cirrhosis and your symptoms. Being diagnosed early and carefully following a treatment plan can help many people with cirrhosis. In the late stages of cirrhosis, certain treatments may not be effective. In that case, your doctor will work with you to prevent or manage the problems that cirrhosis can cause.

What if the cirrhosis treatment doesn’t work?

If too much scar tissue forms, your liver could fail. Then you will need a liver transplant. A liver transplant can return you to good health. For information about liver transplantation, see the booklet What I need to know about Liver Transplantation from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Hope through Research

The NIDDK’s Division of Digestive Diseases and Nutrition supports research into liver diseases such as cirrhosis. Researchers are studying new ways to

prevent cirrhosis

prevent and treat symptoms of cirrhosis

reverse scarring of the liver

Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.

Acknowledgments

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. The National Digestive Diseases Information Clearinghouse would like to thank the following individuals for assisting with the scientific and editorial review of the original version of this publication:

Herbert L. Bonkovsky, M.D.University of Connecticut at Hartford

Michael W. Fried, M.D.University of North Carolina at Chapel Hill

Timothy R. Morgan, M.D.VA Medical CenterLong Beach, CA

Thank you also to Rebecca McBurney, R.N., and Yoon Park, R.N., at the Liver Diseases Branch and Clinical Center, National Institutes of Health, Bethesda, MD, for facilitating field-testing of the original version of this publication.

National Digestive Diseases Information Clearinghouse

The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1980, the Clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. The NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

This publication may contain information about medications. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov. Consult your health care provider for more information.